{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:00:14Z","timestamp":1790316014415,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, unintentional accidents rank among the leading causes of death and disability in children. Despite adequate and appropriate care, survivors commonly experience significant physical and psychosocial sequelae.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine multi\u2010domain health outcomes 6\u2009months after paediatric intensive care unit admission in children sustaining severe unintentional accidents and to identify clinical, demographic and accident\u2010related predictors of suboptimal recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This prospective observational cohort study included children following severe unintentional accidents requiring critical care between 2021 and 2025. Health outcomes were assessed using the Pediatric Quality of Life Inventory 4.0 Generic Core (PedsQL; ages 2\u201318\u2009years) and the PedsQL Infant Scales (ages 0\u201324\u2009months). Parent\u2010reported outcomes were collected 6\u2009months post\u2010injury. Multiple linear regression analyses identified predictors of less favourable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 195 children were included (age 7.1 [SD\u2009=\u20095.3] years, 66.2% male). Transport\u2010related accidents (27.1%) and foreign body aspiration (20.5%) were most common. Mortality was 6.7% (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200913). Among 170 respondents, PedsQL total score was 89.65 (SD\u2009=\u200915.2), physical health summary score was 90.67 (SD\u2009=\u200916.7) and the psychosocial health summary score was 88.27 (SD\u2009=\u200916.6). Prolonged hospitalization (\u03b2\u2009=\u2009\u22120.316,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), older age (\u03b2\u2009=\u2009\u22120.207,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), accident location (\u03b2\u2009=\u20090.160,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036) and injury mechanism (\u03b2\u2009=\u20090.199,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033) were independently associated with less favourable outcomes, explaining 26.4% of total score variance (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.264; adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.227). Domain\u2010specific analyses revealed variable predictors: older age (\u03b2\u2009=\u2009\u22120.268,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and extended hospitalization (\u03b2\u2009=\u2009\u22120.342,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) predicted poorer physical health outcomes; female sex (\u03b2\u2009=\u2009\u22120.214,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and accident mechanism (\u03b2\u2009=\u20090.235,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) predicted emotional difficulties; and accident site (\u03b2\u2009=\u20090.199,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) and mechanism (\u03b2\u2009=\u20090.208,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034) predicted cognitive\/school dysfunction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most children demonstrated substantial recovery at 6\u2009months. However, older age, injury characteristics and prolonged hospitalization were associated with less favourable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Identification of high\u2010risk groups supports targeted, multi\u2010domain follow\u2010up and informs nursing\u2010led, family\u2010centred interventions after paediatric injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70691","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:39:44Z","timestamp":1790314784000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical, Emotional and Social Recovery After Severe Paediatric Accidents: A Six\u2010Month Follow\u2010Up Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0936-368X","authenticated-orcid":false,"given":"Stavroula","family":"Ilia","sequence":"first","affiliation":[{"name":"Postgraduate Program Emergency and Intensive Care in Children, Adolescents and Young Adults, School of Medicine University of Crete  Heraklion Greece"},{"name":"Pediatric Intensive Care Unit, University Hospital, School of Medicine University of Crete  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0348-8649","authenticated-orcid":false,"given":"Aggeliki","family":"Xyrorafa","sequence":"additional","affiliation":[{"name":"Postgraduate Program Emergency and Intensive Care in Children, Adolescents and Young Adults, School of Medicine University of Crete  Heraklion Greece"},{"name":"Nursing Department School of Health Sciences, Hellenic Mediterranean University  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9164-5511","authenticated-orcid":false,"given":"Rozalia","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Orthopedic Department University Hospital, School of Medicine, University of Crete  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5887-1239","authenticated-orcid":false,"given":"Danai Maria","family":"Psoma","sequence":"additional","affiliation":[{"name":"Postgraduate Program Emergency and Intensive Care in Children, Adolescents and Young Adults, School of Medicine University of Crete  Heraklion Greece"},{"name":"Nursing Department School of Health Sciences, Hellenic Mediterranean University  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0928-6183","authenticated-orcid":false,"given":"George","family":"Briassoulis","sequence":"additional","affiliation":[{"name":"Postgraduate Program Emergency and Intensive Care in Children, Adolescents and Young Adults, School of Medicine University of Crete  Heraklion Greece"},{"name":"Pediatric Intensive Care Unit, University Hospital, School of Medicine University of Crete  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_16_2_1","volume-title":"CDC WISQARS \u2013 Web\u2010based Injury Statistics Query and Reporting System","author":"Centers for Disease Control and Prevention","year":"2025"},{"key":"e_1_2_16_3_1","unstructured":"\u201cChild Mortality and Causes of Death \u201daccessed September 11 2025 https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/topic\u2010details\/GHO\/child\u2010mortality\u2010and\u2010causes\u2010of\u2010death."},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.8747"},{"key":"e_1_2_16_5_1","unstructured":"\u201cOlder Children and Young Adolescent Mortality (5 to 14\u2009Years) \u201daccessed September 11 2025 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/older\u2010children\u2010and\u2010young\u2010adolescent\u2010mortality\u2010(5\u2010to\u201014\u2010years)."},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20102667(22)00134\u20107"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)00648\u20106"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211530"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.872469"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010016\u20100523\u20106"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201072161\u20100"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1562237"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002590"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001075"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001476"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/children8040254"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003701"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/children11080948"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2025.12.020"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010199605000\u201000004"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31828a2bbd"},{"key":"e_1_2_16_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103468(87)80006\u20104"},{"key":"e_1_2_16_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010007\u20109294\u20101"},{"key":"e_1_2_16_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010200108000\u201000006"},{"key":"e_1_2_16_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010010\u20109730\u20105"},{"key":"e_1_2_16_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010199902000\u201000003"},{"key":"e_1_2_16_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104733.2008.00487.x"},{"key":"e_1_2_16_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010014\u20100168\u20102"},{"key":"e_1_2_16_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_16_30_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp\u201021\u201061"},{"key":"e_1_2_16_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.3517"},{"key":"e_1_2_16_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2022.100312"},{"key":"e_1_2_16_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010022\u201006852\u2010y"},{"key":"e_1_2_16_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2201761"},{"key":"e_1_2_16_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000905"},{"key":"e_1_2_16_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.01.045"},{"key":"e_1_2_16_37_1","unstructured":"\u201cReduce the Rate of Deaths in Children and Adolescents Aged 1 to 19\u2009Years \u2014 MICH\u201003 \u2013 Healthy People 2030|odphp.health.gov \u201daccessed September 12 2025 https:\/\/odphp.health.gov\/healthypeople\/objectives\u2010and\u2010data\/browse\u2010objectives\/children\/reduce\u2010rate\u2010deaths\u2010children\u2010and\u2010adolescents\u2010aged\u20101\u201019\u2010years\u2010mich\u201003."},{"key":"e_1_2_16_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/08850666251340646"},{"key":"e_1_2_16_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev\u20102012\u2010040658"},{"key":"e_1_2_16_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsv090"},{"key":"e_1_2_16_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10567\u2010012\u20100115\u2010x"},{"key":"e_1_2_16_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.113477"},{"key":"e_1_2_16_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001421"},{"key":"e_1_2_16_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002592"},{"key":"e_1_2_16_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001886"},{"key":"e_1_2_16_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359104513487000"},{"key":"e_1_2_16_47_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2021.5767"},{"key":"e_1_2_16_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.2861"},{"key":"e_1_2_16_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.70057"}],"container-title":["Nursing in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70691","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nicc.70691","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:39:47Z","timestamp":1790314787000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nicc.70691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":48,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/nicc.70691"],"URL":"https:\/\/doi.org\/10.1111\/nicc.70691","archive":["Portico"],"relation":{},"ISSN":["1362-1017","1478-5153"],"issn-type":[{"value":"1362-1017","type":"print"},{"value":"1478-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"2026-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70691"}}